58 Impact of pulmonary hypertension haemodynamic presentation on clinical outcomes in patients with severe symptomatic aortic stenosis undergoing TAVI: insights from the new proposed pulmonary hypertension classification

Background Pulmonary hypertension (PH) frequently co-exists with severe aortic stenosis (AS) and PH severity has been shown to predict outcomes after transcatheter aortic valve implantation (TAVI). The impact of PH haemodynamic presentation on clinical outcomes after TAVI is unknown. Methods and results Of 606 consecutive patients undergoing TAVI, 433 (71.4%) patients with severe AS and a pre-procedural right heart catheterization were assessed. Patients were dichotomized according to whether PH was present (mean pulmonary artery pressure [PAP] ≥25 mmHg) (n = 325) or not (n = 108). PH patients were further dichotomized by left-ventricular end-diastolic pressure (LVEDP) into post-capillary (LVEDP u003e15 mmHG; n = 269) and pre-capillary groups (LVEDP ≤15 mmHg; n = 56). Finally, post-capillary PH patients were divided into isolated (n = 220) and combined (n = 49) subgroups according to whether the diastolic pressure difference (diastolic PAP LVEDP) was normal ( Conclusions Invasive stratification of PH according to haemodynamic presentation predicts acute response to treatment and 1-year mortality after TAVI.